The development of acute renal dysfunction in patient with ST-segment elevation myocardial infarction (STEMI), especially in those who underwent percutaneous coronary intervention, is an actual problem of cardiology, because it worsens the prognosis in those groups of patients. In order to diagnose the acute kidney injury (AKI) in time the search for new biomarkers is going. One of the promising markers is the soluble ST2 (sST2).
Purpose: Estimate the role of various markers in the prognosis of acute kidney injury in patients with STEMI.
Methods: 103 STEMI patients were screened (72.8% male and 27.2% female), mean age was 61.85±12.23 years. A group of patients has been selected (n=70), their creatinine level was determined during the first 24 hours of the disease formation and after 48 hours. All patients were divided into two groups according to acute kidney injury network classification (AKIN): 23 patient in the first group with negative dynamic (1st stage AKIN and higher), 47 patient in the second group without creatinine dynamic. In addition, the levels of sST2, N terminal-pro B-type natriuretic peptide (NT-pro BNP) were determined during the first day of hospitalization.
Results: By comparing the selected groups, a significant difference of creatinine level in the first group has been found (p=0.005), in the second group no significant difference was found. The analysis of biomarkers level (NT pro-BNP, sST2) in both groups showed significant higher level of biomarkers in patients with negative dynamic of creatinine (p≤0.001; χ2 test = 60; p ≤0.001; χ2 test =74, respectively). Moreover, a correlation of high strength has been determined between sST2 and creatinine level (r=0.6; p=0.02) but not between the latter and NT pro-BNP.
Conclusions: The biomarker sST2 can be used for risk stratification in development of acute kidney injury in patients with STEMI; it's more sensitive than the known marker NT- pro BNP. For high prognostic possibility we can use a combination of those biomarkers.